Provider Demographics
NPI:1215275789
Name:LEWIS, LUELLA TONI (MD)
Entity type:Individual
Prefix:DR
First Name:LUELLA
Middle Name:TONI
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:330 W 42ND ST
Mailing Address - Street 2:9TH FLOOR - 900
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-6902
Mailing Address - Country:US
Mailing Address - Phone:212-471-1300
Mailing Address - Fax:212-947-0835
Practice Address - Street 1:330 W 42ND ST
Practice Address - Street 2:9TH FLOOR - 900
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-6902
Practice Address - Country:US
Practice Address - Phone:212-471-1300
Practice Address - Fax:212-947-0835
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY244669207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine